title: Mortality and recurrence patterns of breast cancer patients diagnosed under a screening programme versus comparable non-screened breast cancer patients from the same population: analytical survey from 2002 to 2012.
abstract: Breast cancer screening programmes seem to bring about significant benefits, including decreased mortality, although they may also have some drawbacks such as false-negative and false-positive results. This study aims to compare the clinical outcome of a group of patients undergoing a breast cancer screening programme with that of a synchronous non-screened group of patients matched for age and follow-up period. We studied basic characteristics of epidemiology, immunohistochemistry, loco-regional relapse, distant metastases, disease-free interval and overall and specific mortality. We compared 510 patients in the screened group with 394 non-screened patients, along the period of 2002-2012. Screening was applied on a target population of 49,847 and was based on double-projection, double-read mammograms. Two years were allowed per round. Overall participation for the five rounds considered was 75.2%, with 86.5% coverage, and a total cumulative population of 123,445. The non-participant women amounted 40,794. Tumour detection rate for the screened women was 3.8 per thousand (475/123,445), while the corresponding rate for non-participants was 9.4 per thousand (382/40,797). Incidence of luminal A subtype was 15% higher in screened than that in non-screened patients (95% confidence interval (CI) 8-22%). Conversely, the triple-negative subtype was 6% higher in the non-screened group (95% CI 2-10%). Incidence of breast conservative treatments and sentinel node biopsies was significantly higher in the screened group. Overall mortality was 2.6 times higher in non-screened than that in screened group (95% CI 1.2-5.6) After 10 years of experience with our own screening programme, we believe that included patients receive a benefit versus comparable non-screened breast cancer patients, with acceptable benefit-risk relation.
authors.affiliation: Breast Unit, Department of Gynecology, University Hospital of Mútua Terrassa, Research Foundation Mútua Terrassa, University of Barcelona, Barcelona, Spain, drgarciafdez@hotmail.com.
authors.forename: A
authors.initials: A
authors.lastname: García Fernández
authors.forename: C
authors.initials: C
authors.lastname: Chabrera
authors.forename: M
authors.initials: M
authors.lastname: García Font
authors.forename: M
authors.initials: M
authors.lastname: Fraile
authors.forename: J M
authors.initials: JM
authors.lastname: Lain
authors.forename: S
authors.initials: S
authors.lastname: Gónzalez
authors.forename: C
authors.initials: C
authors.lastname: Corral
authors.forename: M
authors.initials: M
authors.lastname: Torras
authors.forename: J
authors.initials: J
authors.lastname: Torres
authors.forename: M
authors.initials: M
authors.lastname: Teixido
authors.forename: I
authors.initials: I
authors.lastname: Barco
authors.forename: R
authors.initials: R
authors.lastname: López
authors.forename: C
authors.initials: C
authors.lastname: Gónzalez
authors.forename: A
authors.initials: A
authors.lastname: Pessarrodona
authors.forename: N
authors.initials: N
authors.lastname: Giménez
mesh_terms: D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D012008:Recurrence; D013997:Time Factors